Dealing with Dandruff

If dandruff is the only thing standing between you and a closet full of basic black, you're not alone. At any one time, millions of Americans have this chronic scalp disorder, which is marked by itching and excessive flaking of the scalp. Although dandruff isn't contagious and is rarely serious, it can be embarrassing and surprisingly persistent.

Dandruff is a chronic condition that can almost always be controlled, but it may take a little patience and persistence. In general, mild scaling can often be helped by daily cleansing with a gentle shampoo to reduce oiliness and cell buildup.

When regular shampoos fail, OTC dandruff shampoos may succeed. But dandruff shampoos aren't all alike, and you may need to experiment until you find one that works best for you. Dandruff shampoos are classified according to their active ingredient:

Zinc pyrithione shampoos (Suave Dandruff Control Shampoo, Head & Shoulders). These contain the antibacterial and antifungal agent zinc pyrithione, which has been shown to reduce the fungus that causes dandruff and seborrheic dermatitis.

Tar-based shampoos (Neutrogena T/Gel, Tegrin). Coal tar, a byproduct of the coal manufacturing process, helps conditions such as dandruff, seborrheic dermatitis and psoriasis by slowing cell turnover. But coal tar has an "earthy" smell, can give light-colored hair an orange tint and may make treated skin more sensitive to sunlight.

Shampoos containing salicylic acid (Ionil T). These "scalp scrubs" help eliminate scale, but they may leave your scalp dry, leading to more flaking. Using a conditioner after shampooing can help counter dryness.

Selenium sulfide shampoos (Selsun, Exsel). These shampoos help prevent cell turnover and may also reduce the number of malassezia. Because they can discolor blonde, gray or chemically colored hair, be sure to use them only as directed and to rinse well after shampooing.

Ketoconazole shampoos (Nizoral). The newest addition to the dandruff armamentarium, ketoconazole is a broad-spectrum antifungal agent that may work when other shampoos fail. It's available over the counter as well as by prescription.

Try using one of these shampoos daily until your dandruff is controlled, then cut back to two or three times a week. If one type of shampoo works for a time and then seems to lose its effectiveness, try alternating between two types of dandruff shampoos. Be sure to leave the shampoo on for at least 5 minutes — this allows the ingredients time to work. Some experts suggest lathering twice for best results.

If you've shampooed faithfully for several weeks and there's still a dusting of dandruff on your shoulders, talk to your doctor or dermatologist.

Dealing With Dandruff

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